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EXHIBIT D <br />Anaheim and Santa Ana Urban Areas Security Initiative <br />Reimbursement Request for Grant Expenditures <br />Mail Reimbursement Request To: <br />} <br />Sgt. Enrique Esparza, Grant Coordinator <br />Santa Ana Police Department <br />Homeland Security Division <br />60 Civic Center Plaza-P.O. Box 1981 <br />Santa Ana, CA 92702 <br />n This is the final reimbursement request. <br /> <br />Cindy Nickel, Grant Fiscal Coordinator <br />Anaheim Police Department <br />East Station-Homeland Security Bureau <br />425 S. Harbor Boulevard <br />CA 92805 <br />Agency/ City Requesting Reimbursement Payroll Total (Salaries, Overtime, Backfill, etc) <br />Travel Total (Tuition, Meals, lodging, etc) <br />Equipment & Supplies Total <br />Total Amount Requested <br />Under Penalty of perjury, I certify that: <br />I am the duly authorized officer of the claimant herein. This claim is in all respects true, correct, and all <br />expenditures were made in accordance with applicable laws, rules, regulations, and grant conditions and <br />assurances. All attached documents for items and/or services have been received in full. <br />- _':: ?i5 ?t'? .!tf"? ?d?'.ir+tr}..t -r •'.. _. .r-- ..'•--?Ty.,'?[Ln: 6,. <br />Tom Monson <br />Printed Name <br />Chief of Police <br />Title <br />6640 Beach Boulevard <br />Mailing Address <br />Buena Park, CA 90620 <br />City, State, Zip Code <br />Signdture (Please sign In blue ink) <br />(714) 562-3910 <br />Phone Number <br />tmonson@bppd.com <br />E-Mail Address <br />(714) 994-4198 <br />Fax Number <br />? ? sv <br />Date <br />77?? ..+?r-r--r.••rr• -At.sw.-'.r.:c???r7+ 'tiF. n1+.' i?`'?;ti :+.:rr ?;,`,yy1.'Ti•.r-. e.t? t',?•y{?. th rF±'.:t F?x e}'RM`p?C t. C <br />For Anarte ?nx'o0rdYnitoGjsed' . •?` ?'i #";1? T. •, it ti ! ; `".l s. L. e. w •c, G1rl?lt ; t z <br /> <br />roved r Processing Date <br /> <br />Account and AcHvi Number <br /> <br />Grant Year/Grant Project and Solution Area <br /> <br />Special InstructionslCornments <br />38